Provider Demographics
NPI:1639607880
Name:WELSH, SARA MAE MICHELE
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:MAE MICHELE
Last Name:WELSH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:SARA
Other - Middle Name:MAE
Other - Last Name:CARTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L, LMT
Mailing Address - Street 1:1123 N BARDSTOWN RD # 2
Mailing Address - Street 2:
Mailing Address - City:MT WASHINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40047-7843
Mailing Address - Country:US
Mailing Address - Phone:502-538-6333
Mailing Address - Fax:502-538-6334
Practice Address - Street 1:1123 N BARDSTOWN RD UNIT 2
Practice Address - Street 2:
Practice Address - City:MT WASHINGTON
Practice Address - State:KY
Practice Address - Zip Code:40047-7844
Practice Address - Country:US
Practice Address - Phone:502-538-6333
Practice Address - Fax:502-538-6334
Is Sole Proprietor?:No
Enumeration Date:2017-06-01
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY173347225XP0200X, 225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics